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Premium Tax Credit information from IRS:

What is the premium tax credit?

The premium tax credit is an advanceable, refundable tax credit designed to
help eligible individuals and families with low or moderate income afford
health insurance purchased through the Health Insurance Exchange, beginning in
2014. You can choose to have the credit paid in advance to your insurance
company to lower what you pay for your monthly premiums, or you can claim all
of the credit when you file your tax return for the year. If you choose to have
the credit paid in advance, you will reconcile the amount paid in advance with
the actual credit you compute when you file your tax return.

How do I get the premium tax credit?

When you apply for coverage in the Exchange, the Exchange will estimate the
amount of the premium tax credit that you may be able to claim for the tax
year, using information you provide about your family composition and projected
household income. Based upon that estimate, you can decide if you want to have
all, some, or none of your estimated credit paid in advance directly to your
insurance company to be applied to your monthly premiums. If you choose to have
all or some of your credit paid in advance, you will be required to reconcile
on your income tax return the amount of advance payments that the government
sent on your behalf with the premium tax credit that you may claim based on
your actual household income and family size.

If you do not opt for advance credit payments, you may claim the credit when
you file your tax return for the year, which will either lower the amount of
taxes owed on that return or increase your refund.

What happens if my income or family size changes during the year?

The actual premium tax credit for the year will differ from the advance
credit amount estimated by the Exchange if your family size and household
income as estimated at the time of enrollment are different from the family
size and household income you report on your return. The more your family size
or household income differs from the Exchange estimates used to compute your
advance credit payments, the more significant the difference will be between
your advance credit payments and your actual credit. If your actual allowable
credit on your return is less than your advance credit payments, the
difference, subject to certain caps, will be subtracted from your refund or
added to your balance due. If your actual allowable credit is more than your
advance credit payments, the difference will be added to your refund or
subtracted from your balance due.

Notifying the healthplanfinder about changes in circumstances will allow the
healthplanfinder to update the information used to determine your expected amount of
the premium tax credit and adjust your advance payment amount. This adjustment
will decrease the likelihood of a significant difference between your advance
credit payments and your actual premium tax credit. Changes in circumstances
that can affect the amount of your actual premium tax credit include:

Increases or decreases in your household income.

Marriage.

Divorce.

Birth or adoption of a child.

Other changes to your household composition.

Gaining or losing eligibility for government sponsored or employer sponsored health care coverage.

What is household income?

For purposes of the premium tax credit, your household income is your
modified adjusted gross income plus that of every other individual in your
family for whom you can properly claim a personal exemption deduction and who
is required to file a federal income tax return. Modified adjusted gross income
is the adjusted gross income on your federal income tax return plus any
excluded foreign income, nontaxable Social Security benefits (including tier 1
railroad retirement benefits), and tax-exempt interest received or accrued
during the taxable year. It does not include Supplemental Security Income
(SSI).

Will I have to file a federal income tax return to get the premium tax credit?

For any tax year, if you receive advance credit payments in any amount or if
you plan to claim the premium tax credit, you must file a federal income tax
return for that year. If you receive any advance credit payments, you will use
your return to reconcile the difference between the advance credit payments
made on your behalf and the actual amount of the credit that you may claim.
This filing requirement applies whether or not you would otherwise be required
to file a return. If you are married, you must file a joint return to be
eligible for the premium tax credit.

If I get insurance through the Exchange, how will I know what to report on my federal tax return?

The healthplanfinder will send you an information statement showing the amount of
your premiums and advance credit payments by January 31 of the year following
the year of coverage. For example, you will receive the 2014 information
statement by Jan. 31, 2015, and can use this information to compute your
premium tax credit on your 2014 tax return and to reconcile the advance credit
payments made on your behalf with the amount of the actual premium tax
credit.

How is the amount of the premium tax credit determined?

The law bases the size of your premium tax credit on a sliding scale. Those
who have a lower income get a larger credit to help cover the cost of their
insurance. In other words, the higher your income, the lower the amount of your
credit.

Additionally, the premium tax credit is a refundable tax credit. This means
that if the amount of the credit is more than the amount of your tax liability,
you will receive the difference as a refund. If you owe no tax, you can get the
full amount of the credit as a refund. However, if you receive advance payments
of the credit, you will reconcile the advance payments with the amount of the
actual premium tax credit that you calculate on your tax return. If your actual
allowable credit on your return is less than your advance credit payments, the
difference, subject to certain caps, will be subtracted from your refund or
added to your balance due. If your actual allowable credit is more than your
advance credit payments, the difference will be added to your refund or
subtracted from your balance due.

Disclaimer: Washington Health Insurance Exchange is providing the above
information for informational purposes only and should not be considered as tax
advice. This information and more can be found on the IRS website at
www.irs.gov. Always consult a tax professional with regards to your tax
questions and how the ACA tax credits affect you.

A New and Easy Way to Get Covered in Washington.

A Health Insurance Exchange is designed to make buying health coverage
easier and more affordable.

Use this website to see if you’re eligible for tax credits for private
insurance or health programs like the Children’s Health Insurance Program
(CHIP) and Apple Health. Input your household income, county you live in,
and your age. Then simply press the green ‘go’ button.

The calculator will determine if you qualify for new federal financial
assistance that you can use right away to reduce the cost of monthly payments
and out-of-pocket expenses. You’ll be able to compare health plans, their
benefits and premiums, side-by-side.

If you do not qualify for financial assistance, you will be able to
compare your options from top-rated private health carriers offering brand
new plans as of January 1, 2015. All new health plans in Washington cover
pre-existing medical conditions and no one can be turned down for
coverage.

Have questions or need help enrolling? Just call 360-464-1622 and a licensed health insurance professional will answer all of your questions, help you
choose the right health plan to meet your needs, and walk you through the
enrollment process step by step.

What is an Exchange?

All Health Plan Options Under One Umbrella.

Washington Health Insurance Exchange is an approved division of the Washington Health Insurance Agency, featuring top performing producers on Washington’s Healthplanfinder and licensed by the Office of Insurance Commissioner.

Washington Health Insurance Exchange is also an approved agency for each
of the major private health insurance carriers in Washington including
Regence Blue Shield, Premera Blue Cross, Moda Health, LifeWise Health plans
of WA, Assurant Health, Kaiser, Group Health Cooperative and Group Health
Options.

Disclosure: The Washington Health Insurance Exchange website is designed to help Washington residents determine if they qualify for lower health premiums through the Washington Healthplanfinder and enroll in a qualified health plan with the assistance of a licensed broker in the state of Washington. Only independent licensed agents/brokers who are registered producers for Washington’s HealthPlanFinder are authorized to give advice and make recommendations regarding health plans in the healthplanfinder. Washington Health Insurance Exchange is a division of the Washington Health Insurance Agency whose agent/owner is a registered producer for wahealthplanfinder.org and a licensed producer in the state of Washington. Our staff and licensed agents are not government employees, employees of the state, or the Washington Health Plan Finder. We make no claim or claims to represent, constitute, and/or otherwise provide other services on behalf of the Washington HealthPlanFinder. Any and all suggestions, claims, and/or implications to the contrary are hereby denied.

Ten essential health benefits

Starting in 2014, The Affordable Care Act requires health-insurance plans,
both individual and small-group coverage, to provide essential benefits in at
least ten categories. In order to be certified and offered through
healthplanfinder, all policies must cover services in the following
categories.
Read More »

How affordable will the Affordable Care Act be?

The Affordable Care Act, which took affect in 2014, can potentially
entail higher premiums; but it also offers offsetting savings as well. All
health policies will have to cover [10 essential benefits], such as
prescription drugs and rehabilitative care. More robust coverage typically
entails higher costs. Thus, typical premiums for individual and small-group
plans may indeed rise. However, tax credits, subsidized plans and reduced
premiums may make yearly healthcare costs approximately equal or even lower
for those that meet income criteria.
Read More »

What is the premium tax credit?

The premium tax credit is an advanceable, refundable tax credit designed
to help eligible individuals and families with low or moderate income afford
health insurance purchased through the healthplanfinder, beginning
in 2014. You can choose to have the credit paid in advance to your insurance
company to lower what you pay for your monthly premiums, or you can claim all
of the credit when you file your tax return for the year. If you choose to
have the credit paid in advance, you will reconcile the amount paid in
advance with the actual credit you compute when you file your tax return.
Read More »

Frequently Asked Questions

What if I have questions that aren’t answered on the site?

Call us at 360-464-1622. We look forward to answering your questions and helping you choose the plan that’s best for you and your family.

When will I be required to get health insurance?

What is the penalty if I remain uninsured?

Those who remain uninsured after January 1st will be subject to a fine of $95 or 1% of annual income (whichever is greater). Penalty increases to $325 in 2015 (or 2% of income) and $695 or 2.5 percent of household income in 2016.

Why should I visit Health Insurance Exchange?

Health Insurance Exchange is an excellent source for comparing your health coverage options. Multiple providers compete for your business. You can search for plans according to price, coverage options and that include your current doctor. Depending on income level, you may qualify for free coverage or lower premiums and co-pays.

Will I have to change my current health coverage through my job?

Most likely you can keep your plan through your employer. Check with HR to be sure.

Will I still be able to see my current physician?

Health Insurance Exchange enables you to sort plans by provider; so you can choose a plan that includes access to your doctor.

What if I have a pre-existing condition or have been uninsured for an extended period?

Regardless of whether you have a pre-existing medical condition or have gone uninsured for a while, Health Insurance Exchange will enable you to find a health insurance plan that meets you and your family's needs.

I can’t afford health insurance. What now?

If you meet eligibility requirements, you can obtain coverage for free or at deeply reduced premiums. Tax credits, expanded eligibility for Medicaid, and other subsidies will take effect in 2014, helping those in need afford coverage. Under the new law you can see what your estimated premium, deductibles and out-of-pocket costs will be before you enroll.

Is government health insurance available online?

All policies available through Health Insurance Exchange are provided by private insurers. Public insurance programs like Medicaid will have expanded eligibility. Governmental financial assistance may be available for those who meet eligibility requirements.

When is open enrollment?

The second open-enrollment period for buying insurance through an exchange begins November 15, 2014 and ends February 15, 2015. Coverage purchased through exchanges prior to December 23, 2014 will take effect on January 1, 2015.

What if I already have coverage?

If you already have health insurance through your job, Medicaid, Medicare or individual plans, any changes may be minimal. However, you may have access to additional benefits like preventative screenings, emergency services and prescription-medicine coverage. If you pay for your own coverage, you may qualify for new tax credits and financial assistance. You will also be able to insure adult children up to age 26.

Will I quality for a tax credit?

Eligibility is based on yearly household income as follows:
Individuals -- $16,105 to $46,680
Couples -- $21,707 to $62,920
Families of four -- $32,913 to $95,400
Credits are based on a sliding scale, and are NOT available for those who are eligible for Medicaid, Medicare or who are eligible for coverage through an employer Recipients must be a US citizen or lawfully present, not incarcerated and reside in Washington.

Your Privacy is Important! We will not share your personal information with anyone outside of our organization except as required to secure your insurance coverage.
We will not sell or share your personal information with any third party and we will maintain the highest professional standards of confidentiality and integrity.

Washington Health Insurance Exchange is a division of the Washington Health
Insurance Agency whose agent/owner is a registered producer for
wahealthplanfinder.org and a licensed producer in the state of Washington.
Our staff and licensed agents are not government employees, employees of
the state, or the Washington Health Plan Finder. We make no claim or claims
to represent, constitute, and/or otherwise provide other services on behalf
of the Washington HealthPlanFinder. Any and all suggestions, claims, and/or
implications to the contrary are hereby denied.